Dr. Vincent Giacalone
Podiatric Medicine & Surgery
466 Hook Rd., Suite 24D, Emerson, NJ 07630
Nail Disorders and Treatments
In their protective role, nails bear the brunt of daily activities. Walking, running, wearing shoes or participating in sports are just a few of the stresses and strains the feet must endure. All or a portion of the nail can be damaged when the feet are injured or abused. Nail problems are commonly caused by improper trimming, minor injuries or repeated or acute trauma. Some nail disorders can also be congenital. Proper trimming on a regular basis can help keep the toenails in the pink, as can wearing well-fitted, low to moderately heeled shoes.
Painful ingrown nails may be congenital, caused by an over curvature of the nail, or an imbalance between the width of the nail plate and the skin. Toe injuries that change the nail’s contour or improper trimming also can lead to an ingrown toenail. Toe deformities, such as a bunion that forces the big toe to lean toward the second toe, high-heeled or narrow, pointed shoes can put pressure between the nail and skin, eventually forcing the nail to grow into the skin. Symptoms are redness, swelling and infection make the toe very painful. Ingrown nails can be accompanied by other toe disorders, such as excess surrounding tissue or an outgrowth of bone beneath the nail.
Treatments for the Ingrown Nail
A relatively simple in-office procedure is often necessary to ease the pain and remove the offending portion of nail. The procedure requires no cutting of skin or stitches. Only a portion of the nail may be removed under local anesthesia. The nail portion is removed and the matrix or growth center is treated so that that portion of the nail will not grow back. Most people experience very little pain immediately following nail procedure, and during the healing process, which lasts approximately several weeks. The procedure usually does not require medication for pain. You will be given instructions to soak the toe once daily for
several weeks. After the procedure to permanently remove part of the nail, the body generates a hardened skin covering over the sensitive nail bed. When this covering has developed, normal activities can be resumed. Women can also use nail polish on this area. Because the nail matrix has been destroyed, the nail portion removed should not grow again, however the remaining nail will continue to grow normally.
Blood Beneath The Nail
A very common result of an active lifestyle is blood, or a hematoma, beneath the toenail. Hematomas are especially common among people who jog or play tennis, caused by the toes repeatedly rubbing against the shoe. A hematoma might indicate a fractured bone, especially after an injury, such as dropping a heavy object on the end of the toe. The toe should be examined by Dr. Giacalone, who may take an X-ray to determine the most appropriate treatment.
If the hematoma is treated within the first few hours of forming, Dr. Giacalone will create a tiny painless hole in the nail plate using a fine-point instrument. This releases the blood and relieves pain. If several days have passed and the blood clot becomes painful, the nail plate may require removal so that the nail bed can be cleaned. Some podiatric surgeons prefer to remove the nail plate whenever blood forms beneath it, because the blood can attract fungi and lead to infection. The nail may also be removed to treat a bone fracture beneath the hematoma. If the bone has fractured but has not moved out of its normal position, a splint may be used to keep the toe aligned during healing. Nail plates that have been removed will grow again within three to six months.
Dr. Giacalone has been trained specifically and extensively in the diagnosis and medical and surgical treatment of foot disorders. Dr. Giacalone has been board certified by The American Board of Podiatric Orthopedics and The American Board of Podiatric Surgery since 1993 and 1995 respectively and is a Fellow of the American College of Foot and Ankle Surgeons. Dr. Giacalone performs surgery at Hackensack University Medical Center in Hackensack, Hackensack University Medical Center @ Pascack Valley in Westwood and Surgicare Surgical Center in Oradell.